I have been communicating "off the record" with many colleagues that acknowledge the complexity of providing value in the shifting landscape of US healthcare. Here is an anonymized response I gave to the latest executive commenting on just such a concern:

​Ahhh "xxxxx"...welcome to the confusing world of aligning your values with your economies. Brief history--I was a successful medical writer blithely writing content for perhaps the very same pharma and device folks. An amazing career of opportunity (launching drugs from concept to market, ghost writing for leading medical minds, award winning medical content for prestigious academic universities)...but with experience comes awareness. I began to understand the data. I thought clients would appreciate my insights and carefully pointed out discrepancies in the literature and what I was being asked to report or create narrative around.

Well as you know "average" writers are everywhere and are willing to work for average wages. I became the squeaky wheel "sans the grease"... not as much work. I was told "writing is easy if you are a good writer", "don't worry about the data, that is too technical for writers", and other little slogans worthy of a t-shirt. Here is where I see the secret sauce. First of all, we need to band together. We need a presence for many reasons. Redefining patient centricity, creating content around shared-decision making (where patients are informed of benefits AND risks of intervention), and skill sets directed toward physicians and societies. Who says that health economics and data modeling are only for medical affairs departments within the hallowed halls of pharma?

There are many companies that will value insights derived from epigenetics, functional medicine, and high-value care aligned with better patient outcomes. Having said that, I know you realize it is a bit of a Sisyphean task. I receive accolades for my publications--but it is mostly by private message. There is a fear in acknowledging that the ruling paradigm, if not an emperor without any clothes is at least disrobing at an alarming rate.Here is my business model. Give away insights for free. The kind that create head scratching and deep thought. Insights are free but they will come to you for execution and implementation... Look to these organizations for more insights, Lown Institute, Choosing Wisely, Care that Matters, Preventing Overdiagnosis, National Physician Alliance, METRICS (Stanford)...there is a groundswell of activism and I for one would welcome the company :)

So here is hoping that we will be more intentional in 2016. Yes, that is the royal "we". Allow quality and evidence to be your guide. It isn't enough to label everything evidence-based and consider it business as usual. Question the quality of the evidence. The motivation for disseminating the evidence. Who stands to benefit the most from its uptake? Remember the quote by Upton Sinclair...

“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”

Listen to a brief summary of the top talking poins of the NCQA Quality Talk held at the Newseum in DC. Here is the most important highlight for you to consider when creating, absorbing, or sharing content in the healthcare space...For every dollar spent on prescription drugs, another dollar is spent resolving medication related problems--Mary Roth Mcclurg, Pharm.D., M.H.S.

My point today is to let you know that high-value and quality care is accessible. Listening, thinking, communicating, and coordinating in alignment with our values and ethics does not have to be at the expense of our economies.